Ultra-low-dose CT for extremities in an acute setting: initial experience with 203 subjects

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Ultra-low-dose CT for extremities in an acute setting : initial experience with 203 subjects

Alagic, Z. (author): Karolinska Institutet

Bujila, Robert (author): KTH,Medicinsk bildfysik

Enocson, A. (author): Karolinska Institutet

Srivastava, S. (author): Karolinska Institutet

Koskinen, S. K. (author): Functional Unit for Musculoskeletal Radiology Function Imaging and Physiology, Karolinska University Hospital, Karolinska Vägen Solna, 17176 Stockholm, Sweden

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2019-09-09
2020
English.
In: Skeletal Radiology. - : Springer Nature. - 0364-2348 .- 1432-2161. ; 49:4, s. 531-539

Related links:: https://doi.org/10.1...; show more...; https://link.springe...; https://urn.kb.se/re...; https://doi.org/10.1...; http://kipublication...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

ObjectiveThe purpose of this study was to assess if ultra-low-dose CT is a useful clinical alternative to digital radiographs in the evaluation of acute wrist and ankle fractures.Materials and methodsAn ultra-low-dose protocol was designed on a 256-slice multi-detector CT. Patients from the emergency department were evaluated prospectively. After initial digital radiographs, an ultra-low-dose CT was performed. Two readers independently analyzed the images. Also, the radiation dose, examination time, and time to preliminary report was compared between digital radiographs and CT.ResultsIn 207 extremities, digital radiography and ultra-low-dose CT detected 73 and 109 fractures, respectively (p < 0.001). The odds ratio for fracture detection with ultra-low-dose CT vs. digital radiography was 2.0 (95% CI, 1.4–3.0). CT detected additional fracture-related findings in 33 cases (15.9%) and confirmed or ruled out suspected fractures in 19 cases (9.2%). The mean effective dose was comparable between ultra-low-dose CT and digital radiography (0.59 ± 0.33 μSv, 95% CI 0.47–0.59 vs. 0.53 ± 0.43 μSv, 95% CI 0.54–0.64). The mean combined examination time plus time to preliminary report was shorter for ultra-low-dose CT compared to digital radiography (7.6 ± 2.5 min, 95% CI 7.1–8.1 vs. 9.8 ± 4.7 min, 95% CI 8.8–10.7) (p = 0.002). The recommended treatment changed in 34 (16.4%) extremities.ConclusionsUltra-low-dose CT is a useful alternative to digital radiography for imaging the peripheral skeleton in the acute setting as it detects significantly more fractures and provides additional clinically important information, at a comparable radiation dose. It also provides faster combined examination and reporting times.

Subject headings

TEKNIK OCH TEKNOLOGIER -- Medicinteknik -- Medicinsk bildbehandling (hsv//swe)
ENGINEERING AND TECHNOLOGY -- Medical Engineering -- Medical Image Processing (hsv//eng)

Keyword

Multidetector CT . Trauma . Low-dose CT . Radiography . Wrist injuries/treatment . Ankle injuries/treatment . Emergency radiology

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By the author/editor: Alagic, Z.; Bujila, Robert; Enocson, A.; Srivastava, S.; Koskinen, S. K.

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ENGINEERING AND TECHNOLOGY: ENGINEERING AND ...; and Medical Engineer ...; and Medical Image Pr ...

Articles in the publication: Skeletal Radiolo ...

By the university: Royal Institute of Technology; Karolinska Institutet

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